[1]何锋云,欧 琰,丁 莺,等.扶正解秽汤联合重组人干扰素治疗慢性宫颈炎合并高危型 HPV 感染临床研究[J].陕西中医,2024,(5):605-609.[doi:DOI:10.3969/j.issn.1000-7369.2024.05.006]
　HE Fengyun,OU Yan,DING Ying,et al.Clinical effect of Fuzheng Jiehui decoction combined with recombinant human interferon in the treatment of chronic cervicitis complicated with high-risk HPV infection[J].,2024,(5):605-609.[doi:DOI:10.3969/j.issn.1000-7369.2024.05.006]
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扶正解秽汤联合重组人干扰素治疗慢性宫颈炎合并高危型 HPV 感染临床研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年5期
页码:
605-609
栏目:
临床研究
出版日期:
2024-05-05

文章信息/Info

Title:
Clinical effect of Fuzheng Jiehui decoction combined with recombinant human interferon in the treatment of chronic cervicitis complicated with high-risk HPV infection
作者:
何锋云1; 欧 琰1; 丁 莺1; 韦 笑2
(1.桂林市中西医结合医院,广西 桂林 541004; 2.桂林生命与健康职业技术学院,广西 桂林 541004)
Author(s):
HE Fengyun; OU Yan; DING Ying; WEI Xiao
(Guilin Hospital of Integrated Traditional Chinese and Western Medicine,Guilin 541004,China)
关键词:
人乳头瘤病毒;  扶正解秽汤;  重组人干扰素 α-2b凝胶;  慢性宫颈炎;  免疫功能
Keywords:
Human papillomavirus;  Fuzheng Jiehui decoction;  Recombinant human interferon α-2b gel;  Chronic cervicitis;  Immune function
分类号:
R 711.74
DOI:
DOI:10.3969/j.issn.1000-7369.2024.05.006
文献标志码:
A
摘要:
目的:观察扶正解秽汤联合重组人干扰素治疗慢性宫颈炎合并高危型人乳头瘤病毒(HPV)感染的临床疗效。方法:选择160例慢性宫颈炎合并高危型HPV感染患者,随机分为两组,对照组(80例)阴道内给予重组人干扰素 α-2b凝胶栓治疗,观察组(80例)在其基础上联用扶正解秽汤治疗,疗程均为3个月。记录两组临床疗效,比较治疗前后两组中医症状积分、宫颈炎评分和HPV病毒载量的变化,记录阴道分泌物恢复正常时间、宫颈糜烂面愈合时间和HPV转阴率。 比较两组细胞免疫指标与宫颈局部免疫微环境的变化。记录两组复发率与不良反应。结果:观察组与对照组临床总有效率分别为95.00%和76.25%,前者显著高于后者(P<0.05)。与治疗前比较,两组治疗后中医症状积分、宫颈炎评分和HPV病毒载量、血清CD8+、阴道灌洗液白细胞介素-10(IL-10)水平显著降低(P<0.05),且观察组治疗后上述指标均低于对照组(P<0.05),两组治疗后血清CD3+、CD4+、CD4+/CD8+比值、阴道灌洗液sIgA、IL-2均明显增高(P<0.05),且观察组治疗后上述指标均高于对照组(P<0.05)。观察组宫颈糜烂面愈合与阴道分泌物恢复正常时间均短于对照组,HPV转阴率高于对照组(P<0.05)。观察组治疗后随访6个月的复发率低于对照组,两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:在重组人干扰素治疗基础上,加用扶正解秽汤能够显著改善慢性宫颈炎合并高危型HPV感染患者症状,提高治疗疗效,降低病毒载量,提高HPV转阴率,降低复发率,其机制可能与其调节机体细胞免疫,改善宫颈局部免疫微环境有关。
Abstract:
Objective:To observe the clinical efficacy of Fuzheng Jiehui decoction combined with recombinant human interferon in the treatment of chronic cervicitis complicated with high-risk human papillomavirus(HPV)infection.Methods:A total of 160 patients with chronic cervicitis and high-risk HPV infection were enrolled,randomly divided into two groups:the control group(80 cases)was treated with recombinant human interferon α-2b gel suppositories intravaginally,and the observation group(80 cases)were treated with Fuzheng Jiehui decoction on the basis of Fuzheng Jiehui decoction,and the course of treatment was 3 months.The clinical efficacy of the two groups was recorded,and the changes of TCM symptom score,cervicitis score and HPV viral load were compared between the two groups before and after treatment,and the time for vaginal discharge to return to normal,the healing time of cervical erosion surface and the rate of HPV conversion to negative were recorded.The changes of cellular immunity indexes and cervical local immune microenvironment were compared between the two groups.The recurrence rate and adverse reactions were recorded in the two groups.Results:The total effective rate of the observation group was 95.00%,which was significantly higher than control group(76.25%)(P<0.05).Compared with those before treatment,the TCM symptom score,cervicitis score,HPV viral load,serum CD8+ and interleukin-10(IL-10)levels of vaginal lavage fluid were significantly decreased after treatment in both groups(P<0.05),and those indexes in observation group were lower than control group(P<0.05).After treatment,and the serum CD3+,CD4+,CD4+/CD8+ ratio,sIgA in the vaginal lavage solution,and IL-2 was significantly increased(P<0.05),and those indexes in observation group were higher than control group(P<0.05).The healing time of cervical erosion and vaginal discharge in observation group were shorter than control group,rate of HPV conversion was higher than control group(P<0.05).The recurrence rate of observation group was lower than control group after 6 months of treatment,and there was no significant difference in incidence of adverse reactions between the both(P>0.05).Conclusion:On the basis of recombinant human interferon therapy,the addition of Fuzheng Jiehui decoction can significantly improve the symptoms,improve the treatment efficacy,reduce the viral load,increase the rate of HPV conversion and reduce the recurrence rate in patients with chronic cervicitis and high-risk HPV infection,and the mechanism may be related to the regulation of body cellular immunity and the improvement of the local immune microenvironment of the cervix.

参考文献/References:

[1] 高会影,赵艳玲,陈丽丽,等.抗宫炎片和壳聚糖宫颈炎菌膜治疗慢性宫颈炎的有效性研究[J].河北医药,2021,43(8):1200-1203.
[2] 卿荣珍,黄川雨,刘新月,等.壮医药线灸治疗慢性宫颈炎合并人乳头瘤病毒感染疗效观察[J].上海针灸杂志,2022,41(4):376-380.
[3] 王妮,王佩,宋雪妮,等.妇科千金胶囊联合重组人干扰素α-2b治疗慢性宫颈炎伴人类乳头瘤病毒感染59例临床观察[J].广东医科大学学报,2022,40(6):694-696.
[4] 苏航,范雪,艾浩.不同生育期女性高危型HPV感染调查及相关危险因素分析[J].陕西医学杂志,2021,50(8):1023-1026.
[5] 陈一蕊,勾朝阳,李新阳.宫颈癌患者血清miR-3607-3p水平与人乳头瘤病毒感染相关性[J].中国计划生育学杂志,2022,30(2):470-473.
[6] 谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:254-257.
[7] 冯晓玲,张婷婷.中医妇科学[M].5版.北京:中国中医药出版社,2021:187.
[8] 中华医学会.临床诊疗指南:妇产科学分册[M].北京:人民卫生出版社,2007:102.
[9] 国家食品药品监督管理局.中药新药临床研究指导原则(试行)[M]. 北京:中国医药科技出版社,2002:211-212.
[10] 徐丛剑,华克勤.实用妇科学[M].4版.北京:人民卫生出版社,2017:211.
[11] 夏金多,吕春亮,闫萍,等.清热通利汤对宫颈炎并HPV感染患者生化指标与临床症状的影响研究[J].陕西中医,2020,41(11):1607-1610.
[12] 刘红卫,刘郁明,成艳.子宫颈病变2015例与高危型HPV感染情况分析[J].陕西医学杂志,2010,39(10):1327-1328.
[13] 王伊洁,杨玮丽,李慰,等.宫颈高危型人乳头瘤病毒感染患者阴道微生态和外周血T淋巴细胞亚群分析[J].中国妇幼保健,2021,36(14):3342-3346.
[14] LI B,WANG H,YANG D,et al.Prevalence and distribution of cervical human papillomavirus genotypes in women with cytological results from Sichuan province,China[J].Journal of Medical Virology.2019,91(1):139-145.
[15] 刘瑾,陈雨,陈远群,等.宫颈HPV感染者T淋巴细胞亚群、炎症因子水平变化分析[J].中国计划生育学杂志,2020,28(8):1270-1273.
[16] 刘家秀,李玉叶.人乳头瘤病毒感染与阴道微生态关系的研究进展 [J].中国皮肤性病学杂志,2021,35(7):816-819.
[17] 何淑莹,贾小文,杨蕾.下生殖道感染与阴道局部免疫的关系[J].陕西医学杂志,2016,45(10):1297-1298.
[18] 季璇,蔡云朗.阴道微生态与HPV感染及宫颈病变相关性的研究进展[J].东南大学学报(医学版),2021,40(3):410-414.
[19] 谭超月,张庆庆,李元,等.宫颈病变患者血清和阴道灌洗液中IL-2、IL-4、IFN-γ的表达及相关性研究[J].实用妇产科杂志,2018,34(7):515-518.
[20] 付枭,王蓉,陈智慧,等.宫颈感染HPV患者相关免疫指标水平的变化及意义[J].国际病毒学杂志,2022,29(6):492-495.
[21] 沈丽,薛平莉,朱燕娜.HPV感染及其基因型与宫颈病变患者病灶微环境Th1/Th2平衡及疾病进展的关系[J].中华医院感染学杂志,2022,32(16):2510-2514.
[22] 曹泰华,刘双爱,赵祖国.宫颈病变患者血清白细胞介素2、白细胞介素4、干扰素γ水平与高危型HPV感染相关性研究[J].陕西医学杂志,2023,52(11):1546-1549,1553.
[23] 赵文斌,陈淑慧,王哲.四妙丸联合重组人干扰素α-2b凝胶治疗尖锐湿疣的临床疗效观察及HPV检测分析[J].中国中西医结合皮肤性病学杂志,2023,22(1):56-58.
[24] 陈家旭.中医诊断学[M].北京:人民卫生出版社,2012:176-181.
[25] 陈冬梅,蒙洁,刘佳佳,等.基于网络药理学的党参增强免疫功能机制研究[J].中华中医药学刊,2020,38(2):184-187,后插30-后插31.
[26] 沈映君,陈长勋.中药药理学[M].上海:上海科学技术出版社,2012:37-398.
[27] 黄玉普,吴大章,王森.黄芩的药理作用及其药对研究进展[J].中国药业,2022,31(15):后插1-后插5.
[28] 吕艳艳,薛阳利,陶美花,等.黄芩苷联合干扰素α治疗乙型肝炎肝纤维化临床研究[J].陕西医学杂志,2018,47(5):643-645.

备注/Memo

备注/Memo:
基金项目:广西壮族自治区中医药管理局科研课题(GXZYC20230607)
更新日期/Last Update: 2024-05-09